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Partner & Litigation Chair

Karen Rich, Esq.

Seasoned trial counsel for senior living facilities, healthcare providers, insurers, and operators facing high-exposure civil litigation.

Karen Rich serves as Partner and Litigation Chair at Garbacz Zlotowitz Rich LLP, where she leads the firm's long-term care and healthcare litigation practice. Karen, along with her team, provides practical, cost-conscious legal representation designed specifically for the operational, regulatory, and litigation challenges faced by skilled nursing facilities (SNFs) and assisted living facilities (ALFs), as well as the employment, premises liability, vendor, and regulatory matters that arise across their operations. Services are delivered with an emphasis on early issue identification, cost containment, and seamless integration with facility leadership and staff.

PRACTICE AREAS

  • SNF / ALF Litigation & Risk Management
  • Employment Claims & Workforce Matters
  • Premises Liability
  • Vendor & Third-Party Disputes
  • Regulatory & Survey Matters
  • Risk Management, Training & Crisis Response

Scope of Services

Administrative & Litigation Support for SNF/ALF Operations
  • Review and timely response to insurance requests, including preparation of redacted insurance policies and declaration sheets
  • Review and timely response to records requests to ensure HIPAA compliance
  • Access and management of electronic documentation systems to obtain complete electronic records, and coordination with medical records custodians to obtain complete paper medical records, including labs, imaging, consults, physician notes, therapy records, hospital records and administrative files
  • Organization of nursing home charts in a consistent, bookmarked, and searchable format for ease of reference
  • Maintenance of a facility document library to reduce repetitive collection burdens across overlapping matters, including:
    • Staffing and census records
    • Policies and procedures
    • Employee files and training/in-service materials
    • Surveys, plans of correction, and regulatory correspondence
    • Resident council documentation
    • Consulting, medical director, and vendor agreements
  • Service as registered agent and/or receipt of service of process to ensure timely response and assignment
  • E-discovery strategy and document preservation, including litigation holds and coordination with EMR and IT vendors
Survey, Regulatory & Immediate Jeopardy Response
  • Real-time legal guidance during state and federal surveys, including Immediate Jeopardy situations
  • Counsel during survey exit conferences
  • Drafting and revision of Plans of Correction to ensure regulatory compliance while minimizing admissions
  • Coordination with consultants during revisit surveys
  • Defense of DOH/AHCA licensure actions and regulatory enforcement matters
  • Support with AHCA Certificate of Need (CON) applications, Change of Ownership (CHOW) filings, and related licensure transactions
  • Code enforcement matters at the local, state, and federal level
Resident Discharge & Transfer Hearings
  • Counsel on 30-day discharge and transfer notice language to ensure statutory and regulatory compliance
  • Defense of resident and family appeals at discharge hearings
  • Guidance related to Medicaid eligibility disputes impacting discharge or placement decisions
Violation of Resident Rights – Pre-Suit Representation
  • Review of Notices of Intent for standing, statute of limitations, and statutory compliance
  • Attorney-led chart review without routine reliance on nurse consultants, reducing costs
  • Targeted staff interviews when necessary to evaluate claims
  • Strategic utilization of DONs and regional consultants for nursing standard-of-care input to avoid unnecessary expert expenses
  • Propounding and responding to pre-suit discovery and document requests
  • Attorney review of materials received, including medical records, photographs, billing records, liens, and death certificates
  • Limited unsworn statements of claimants conducted via Zoom (no court reporter) to conserve costs
  • Preparation of mediation and settlement evaluations
  • Early, informal settlement negotiations aimed at achieving a reasonable resolution prior to mediation or litigation
  • Resident and family background checks when appropriate
  • Attendance and representation at mediation
Violation of Resident Rights – Litigation Defense
  • Preparation of responsive pleadings asserting all viable defenses, including:
    • Enforcement of arbitration agreements
    • Lack of standing
    • Statute of limitations
    • Exclusive remedy
    • Personal jurisdiction
    • Passive investor and corporate-structure defenses
  • Preparation and review of initial disclosures
  • Strategic discovery practice, including propounding and responding to written discovery
  • Depositions of parties, staff, families, treaters and experts as needed
  • Cost-conscious approach to non-party records:
    • Initial production requests to Plaintiffs to assess completeness
    • Waiver of custodians where appropriate
    • Confer with opposing counsel before incurring costs associated with motion practice
  • Preparation for and defense through binding arbitration or jury trial
Incident Response & Crisis Management
  • Rapid legal guidance following sentinel events (falls with injury, elopement, abuse allegations, unexpected death)
  • Counsel regarding mandatory reporting obligations and timelines
  • Privileged internal investigations following adverse incidents
Employment Claims & Workforce Matters
  • Union grievances from strike conference through binding arbitration
  • Defense of EEOC charges, mediations, and discrimination lawsuits
  • Whistleblower claims
  • Wage and hour disputes, including unpaid overtime
  • Licensure and disciplinary matters involving staff
  • Severance and separation agreements
  • Risk management support, including:
    • Disciplinary action documentation
    • Corrective action plans
    • FMLA and accommodation requests
    • Training for administrators and management on documentation and investigation best practices
Vendor, Medical Director & Third-Party Disputes
  • Negotiation of excessive vendor invoices (staffing agencies, wound care providers)
  • Breach of contract disputes
  • Review and negotiation of medical director and provider agreements
  • Guidance regarding physician documentation and accountability issues
  • Premises liability and negligence claims
Premises Liability – Visitor & Invitee Issues
  • Trespass warnings and visitor management
  • Premises liability claims
  • HIPAA guidance related to visitors and third parties
Risk Management, Training & Portfolio Support
  • Documentation and compliance education seminars
  • Mock surveys and survey-readiness counseling
  • Adverse incident analysis and trend identification
  • Policy and procedure development and review
  • Arbitration agreement program design, implementation, and auditing
  • Staff and leadership training on proper execution and enforceability of arbitration agreements
  • Mock depositions and hearing preparation for administrators, DONs, and key witnesses
  • Portfolio-level risk assessment and trend analysis for multi-facility operators
Advance Directives & Health Care Decision-Making Documents
  • Preparation of durable powers of attorney (health care and financial)
  • Health care surrogate designations and living wills, including customized directives addressing religious or faith-based restrictions on treatment (e.g., refusal of blood products, end-of-life care consistent with religious doctrine)
  • Age-of-majority planning packages for young adults turning 18, ensuring parents/guardians retain access to medical and educational information once a child reaches legal adulthood
  • Guidance on execution formalities and witness/notary requirements to ensure documents are enforceable across jurisdictions
  • Representation in judicial proceedings to establish health care surrogate authority or incapacity determinations when no advance directive exists (In re: Health Care Decisions matters)
ABA & Behavioral Health Provider General Counsel Support
  • Karen and her team serve as outside general counsel to ABA therapy practices and behavioral health providers, protecting clinical operations from the legal exposure that comes with treating vulnerable, often court-involved populations.
  • HIPAA compliance counseling, including guidance on permissible disclosures, authorization requirements, and responding to subpoenas seeking clinical records or therapist testimony
  • Litigation support when providers or their staff are subpoenaed to testify in third-party proceedings (e.g., family court custody matters), including negotiating the scope of permitted testimony, seeking protective orders, and shielding clinical staff from being drawn into disputes outside their control
  • Coordination with opposing counsel and the court to secure sealed filings, closed proceedings, or in-camera review where a minor's or patient's privacy is at risk
  • Internal HIPAA audits and policy review to identify gaps before they become compliance issues
  • Staff training on HIPAA obligations, including what clinicians can and cannot say when contacted directly by outside attorneys or family members
  • Guidance on documentation practices, informed consent, and treatment authorization records
  • Contract review for provider agreements, vendor relationships, and payor arrangements

Bar Admissions

Admitted to practice in Florida

Admitted to practice in Massachusetts

Chair 2026-2027, Vice Chair 2026-2026, ADR Section of St. Petersburg Bar Association